Concise report
Reversibility of histological and immunohistological
abnormalities in sublabial salivary gland biopsy specimens
following treatment with corticosteroids in Sjögren's syndrome
M M Zandbelta, F H J van den Hoogena, P C de Wildeb, P J S van den Bergc, H G F Schneiderd, L B A van de Puttea
a Department of
Rheumatology, University Medical Centre St Radboud, Nijmegen,
Netherlands, b Department of Pathology,
University Medical Centre St Radboud, Nijmegen, c Department of Neurology, Sophia Hospital,
Zwolle, Netherlands, d Department
of Ophthalmology, Elkerliek Hospital, Helmond, Netherlands
Correspondence to: Dr M Zandbelt, Department of Rheumatology, UMC St Radboud, Nijmegen , P O Box 9101, 6500 HB Nijmegen, Netherlands M.Zandbelt{at}reuma.azn.nl
Accepted for publication 30 November
2000
Sjögren's syndrome (SS) is a chronic autoimmune disease
characterised by specific lesions in exocrine glands, so sublabial minor salivary gland biopsy (SLGB) plays an important part in its
diagnosis. The extent and composition of the lymphocytic infiltrate in
SLGB specimens can be considered as target organ specific parameters. They are quantified after histological and immunohistological examination by a focus score (describing the extent of the infiltrate) and IgA% score (describing the composition of the infiltrate), respectively. However, little is known about the factors that contribute to the extent and composition of the infiltrate and whether
these features are reversible as repeated SLGBs are rarely performed. A
patient with SS is described who underwent SLGBs before and after
treatment with high dose corticosteroids. After treatment there was not
only clinical improvement, but also improvement in the histological and
immunohistological parameters. Although these findings need to be
confirmed in further studies, this suggests that histopathological
changes may be reversible in SS. Furthermore, it shows that the
potential effects of corticosteroid use should be taken into
account when interpreting SLGB specimens. When clinical changes do
parallel histological changes, repeated SLGBs might offer a marker for
disease activity in patients with SS.
© 2001 by Annals of the Rheumatic Diseases
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